It's an inherently anti-egalitarian culture when you have to ask a nurse for permission to give more than 100mcg of fentany because someone believes there's danger there.
Rocket, you don't know what you don't know. This is not the case where I am, nor how I practice. Nurse or not, pain management starts all adults at 100 mcg.
It's an inherently anti-egalitarian culture when a simple vent call or a drip requires an RN. But for the vast majority of ground EMS, to include ALS transfers, the CA model is really, really regressive.
This is correct, and with that I will agree.
It's an inherently anti-egalitarian culture when 1975's "the private ambulance driver shouldn't speak" is still actively sustained.
Again, a misconception perhaps you've either come to conclude, or are going off of word-of-mouth.
Having spent a good half of a decade alongside these "fabulous folks" I very much spoke what I felt needed speaking of, or for.
This train-of-thought EMT is often the same ones who want nothing more than to be in their (fire's) shoes, and therefore live in fear of their applications being pushed back because of it.
I met some good people, and made some friends along the way, all while being kicked out of cities, taking them for joyrides, and earning their respect whether they liked it or not. I'll say it again- I learned a lot...indirectly.
I surely did not fit in all too well there in the long run, and ultimately left because of it, but assuming every EMT abides by this mantra is just not accurate.
The ones that I know that are still down there fighting that fight because they have, or had, no other out or option have my respect.
lol. Part of this that sparked me is i just recently talked to one of my old athletic trainers in college who has the EMS equivalent of alphabet soup (MS,ATC, CSCS, facial stretch, the whole kit and kaboodle) and she rejuvenated my interest clearly not as a full time job tho. I also want to work a lot while im young to get it over with 
